National Health Database: Good Medicine Or Privacy Nightmare? - InformationWeek

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National Health Database: Good Medicine Or Privacy Nightmare?
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Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 2:53:41 PM
Re: Interoperability is positive, but accurate patient ID is the linchpin
Absolutely true: We cannot wait for a 100% impenetrable database. If we do, we'll never get anywhere! And you'd certainly imagine biometric developers are at the head of the security process for ensuring the protection and integrity of such personal information. 

One interesting tidbit I learned regarding biometrics in healthcare: Fingerprints can be challenging since so many healthcare positions require users to wear latex (or similar) gloves. It's one reason I think iris scans will be a big boon in this sector at some point, at least among employees (if not patients, too). In one case, a relatively high percentage of pilot users had to resort to the back-up mode to log on because they couldn't operate the system due to their gloves. Some developers have, however, figured this out, apparently, and have fingerprint systems that take gloves into account. Anyone know more about this?
Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 2:50:12 PM
Re: Another Epic Government Fail to Screw Americans
Well, yes, most people want a system that cannot be hacked. I don't necessarily think security is the highest priority for healthcare providers, as a rule. That's not to say some providers don't do an excellent job of securing data. They do. But some have not invested enough or the right resources to secure data or privacy. There are many reasons why: There are so many mandates and only so many dollars and people, and obviously something has to give! The type of security needed now in healthcare is foreign to the industry, which hasn't historically needed to think of data in this manner or scope. And it's challenging to find the money or the people to fill the needs, especially as so many other industries -- often higher paying -- are competing for the same people. That said, excuses don't protect our information and many healthcare providers have figured out a way to safeguard our information.
Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 2:46:49 PM
Re: Safety and security
I've seen articles that demonstrate how much medical information is out there based on our own social media posts. Software can troll through Facebook, Twitter, etc., to discover all those posts about headaches, flu, stomachaches, etc., and determine who has what and when. I do worry about the patient-focused support groups for chronic conditions -- online forums hosted by healthcare providers, pharma companies, or patients. While they are generally a great idea since patients (and caregivers) can learn about new cures and treatments, best practices, get mental and emotional support, and educate themselves about the condition, I do wonder just how much information is accessible about members if somebody wanted to learn that data for nefarious reasons. 

OTOH, a number of people tell me a growing number of patients are open about their conditions, hopeful their transparency will prompt more research, understanding, and treatments. As with everything medical, I believe it HAS to be transparent and opt-in: If you want to share information, go for it -- but that decision has to be in readily understandable non-legalese and must be up to the patient.
M2SYS
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M2SYS,
User Rank: Apprentice
8/27/2014 | 2:30:25 PM
Re: Interoperability is positive, but accurate patient ID is the linchpin
Thanks for the feedback Alison and you bring up a valid point when referring to assurances that if you provide your biometric information, it is kept safe and secure. We should preface this with saying that there isn't a database on this planet that isn't susceptible to hackers - and it is a disservice to the indutsry to claim that database security could "never" be compromised.

With that in mind, most biometric identification providers take great measures to ensure that patient identities are secured starting with strong encryption of enrollment templates. Most people don't realize that there isn't an image of your fingerprint, or iris stored on a database - instead it's a series of unique data points that have been mapped out based on an image of your biometric credential so the likelihood that a hacker could let alone breach a biometric database and reverse engineer your template to create an image of your biometric credential is extremely slim. Second, most biometric capture devices are now equipped with very sophisticated "liveness" detection technology that prevents spoofing and makes it nearly impossible. Meaning, if someone were to reverse engineer a biometric enrollment template and attempt to use it claiming the identity of another person, most biometric devices have technology that can decipher a fake image from a real one or contain multimodal capabilities - meaning that the device measures two biometric credentials, not one, making it next to impossible for an impostor to fool.

So the biometrics industry has implemented safeguards that help protect your credentials and ensure thay they are kept safe and out of the hands of criminals or hackers.  
Henrisha
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Henrisha,
User Rank: Strategist
8/27/2014 | 2:22:35 PM
Re: Consider the source
I agree. If you work with people who might have alternate motives, then you're basically better off working alone.
Henrisha
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Henrisha,
User Rank: Strategist
8/27/2014 | 2:21:43 PM
Re: Another Epic Government Fail to Screw Americans
There are pros and cons to every new piece of technology that is introduced. To come up with a hack-proof system that keeps patients' records and information private in the event of a hack is something that experts are already working on.
Henrisha
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Henrisha,
User Rank: Strategist
8/27/2014 | 2:20:57 PM
Re: Safety and security
At the rate things are going--privacy breaches, data hacks, and whatnot--what information of ours, that is supposedly private, isn't already out there, I wonder?
Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 12:54:48 PM
Re: Sounds like a fairy tale more than a nightmare
Yes, everyone I spoke to basically agreed we won't have one big database a la Britain's NHS. But I think we're moving to a de facto system of multiple, interconnected databases that serve the same purpose. Not sure when that will happen. As we all know, all HIXs aren't exactly meeting their projected dates and goals! Eventually, however, all 50 states will no doubt have some form of HIX and multiple ACOs, all of which inter-communicate data on all patients. Combine that with the huge percent of patients covered by government -- Medicare, Medicaid, VA, Tristar, jail/prison -- and you've already got a big portion of the nation's population in a national database of sorts.
Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 12:51:37 PM
Re: Interoperability is positive, but accurate patient ID is the linchpin
Really good point, M2SYS. I recall, years ago, seeing one specialist who was ahead of the curve in including digitally taken photos into patient records. It was reassuring, especially given the nature of the specialty he had, to know it would be more diffiicult for someone else to pretend to be me at an appointment. Of course, tech has come a long way since then as you point out, and biometrics are much less expensive and easier to implement. However, I would want reassurance that related securities also protect the actual data to ensure thieves couldn't steal not only my medical records, insurance, and credit card info, but also my fingerprint/iris scan!
Alison_Diana
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Alison_Diana,
User Rank: Author
8/27/2014 | 12:48:31 PM
Re: Another Epic Government Fail to Screw Americans
As I see it, we now have the worst of both worlds as patients. We still have to complete reams of paperwork whenever we start at a new doctor's office but insurers and most physician offices can access our records electronically to find other physicans' notes, billing information, or to get us to pay that growing co-pay. All that digitization leads to increased risk of hacking or illicit access -- but we seldom (I've never yet, to be honest) reap the benefits we're supposed to. Until that day comes, the healthcare system will have a tough time arguing we're in better shape.
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